Eye-Lid approach for four zigomatic implant placement in the severely reabsorbed maxillae: technical note

Up to date, zygomatic implants (ZIs) have been considered a predictable treatment modality for cases of atrophic maxilla. In some severe cases with severe vertical and/or horizontal bone resorption in the anterior maxilla, the placement of standard implants in the anterior area represents a challenge. In these arduous scenarios, performance of a zygomatic "quad-approach" might be advocated. Nevertheless, in limited zygomatic bone width, orbital cavity perforation constituted a potential risk that must be controlled during surgery. This paper focused at presenting a novel technique modification of conjunctival incision to expose the inferolateral orbital rim by an ophthalmologist, to assist the oral surgeon to have direct visualization of the orbital margin and to easily control the drilling direction. With this modification, the potential risk of orbital cavity penetration and its content damage could be diminished and ZIs might be well placed on accordance to prosthetically planned position.